The latest research shows that almost everyone needs to hold the salt.

It’s a critical flavor enhancer for so many foods, and in centuries past, it was necessary for preserving perishables before the advent of refrigerators. But salt, alas, is one of the many factors plaguing American health. The American Heart Association (AHA) links too much salt in the diet to a higher risk for heart disease, hypertension and stroke, and according to research presented this week at the AHA’s 2013 Scientific Sessions, excessive salt led to nearly 2.3 million heart-related deaths worldwide in 2010.

The researchers analyzed 247 surveys of adults participating in the 2010 Global Burden of Disease Survey, which is a collaborative study involving researchers from 50 different countries. The participants reported on their sodium intake from 1990 to 2010 in food questionnaires. Overall, adults around the world ate an average of 4,000 mg of sodium a day, either from prepared foods or from table salt, soy sauce or additional salt sprinkled into meals while cooking. That’s twice the amount recommended by the World Health Organization (2,000 mg per day) and nearly three times the amount the AHA says is healthy (1,500 mg per day).

Of the 187 countries represented in the surveys, 181, home to 99% of the world’s population, exceeded the World Health Organization’s salt limit; only Kenya adhered to the AHA’s recommendation.

To emphasize the contribution that high sodium intake can have on health, the researchers then conducted a meta-analysis of 107 trials that measured the relationship between participants’ salt consumption and blood pressure and heart-disease risk.

Among people dying from heart attacks, strokes or other heart-related disorders, 40% were premature and occurred in people 69 and younger. Excessive salt intake — defined as anything above 1,000 mg per day — was linked to 84% of the deaths, and the majority occurred in low- and middle-income countries.

Out of the 30 largest countries in the world, the U.S. ranked 19th, with 429 deaths per million adults due to excessive salt consumption.

The Salt Institute criticized the study, noting that the added heart-disease risk was compared with an unrealistically low level of salt consumption that no country in the world met. “This latest AHA statistical study on the worldwide mortality from dietary salt is misleading and totally devoid of genuine evidence,” said Morton Satin, vice president of science and research for the Salt Institute, in a statement. “Using a highly flawed statistical model, researchers simply projected potential reductions in mortality without considering all known health risks resulting from low salt intake.”

Still, adults are not the only ones at risk. In other research presented at the AHA meeting, scientists reported that children are already eating too much salt as well. The high sodium content in prepackaged meals and snacks targeted at kids is pushing them to eat unhealthy amounts. About 75% of prepackaged meals are high in sodium, according to data that analyzed the salt content in 1,115 products for babies and toddlers.

In the analysis, the researchers defined “high in sodium” as containing over 210 mg per serving, and they found that some toddler meals contained up to 630 mg of sodium per serving. “Our concern is the possible long-term health risks of introducing high levels of sodium in a child’s diet, because high blood pressure, as well as a preference for salty foods, may develop early in life. The less sodium in an infant’s or toddler’s diet, the less he or she may want it when older,” said lead author Joyce Maalouf, a fellow at the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention in Atlanta, in a statement.

And the AHA says it’s worth remembering that salt doesn’t just come in the shaker on the table. Because it’s hidden in so many prepackaged and prepared foods, it’s important to read labels and nutritional information for things you don’t make yourself. And when cooking, keep salt to a minimum and try substituting with other flavors, like the sourness of lemon juice, to trick your taste buds into thinking they’re getting salt.